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Suggest Treatment For Sterile Pyuria
Question: I am retired in excellent physical condition in spite of my medical history. I have had Stage 3 renal disease for 8 years. Numbers are good. Bun, 20, Creatinine, 1.34. Also, microalbumin,, microalbumin/creatinine ratio etc.Since November of 2014nth I have had 50-60 wbc in urine. Culture for bacterial growth always negative. I have had 2 week course of cipro and 3 week course of doxycycline, UA sent this week with same results 50-60 wbc, no bacteria. Culture negative.
When I had my partial open nephrectomy in 2009 small tumor removed. Procedure was done as open procedure to spare kidney because of my DM and renal disease. Unfortunately, about 6 weeks after procedure for whatever reason, kidney shut down. Most recent US in January showed almost no evidence of remaining kidney. No evidence of calculi. A!C 5.8
What is going on? Even with my good renal labs an urine numbers could there be some inflammatory process from remaining healthy kidney or perhaps some sloughing of tissue from what remains of right kidney causing pyuria. MY urologist and PCP say no more need for antibiotics.
I feel great, no urinary symptoms. My obvious concern is potential eventual ascending pyelonephritis into one remaining kidney. What is your best guess? Thanks
When I had my partial open nephrectomy in 2009 small tumor removed. Procedure was done as open procedure to spare kidney because of my DM and renal disease. Unfortunately, about 6 weeks after procedure for whatever reason, kidney shut down. Most recent US in January showed almost no evidence of remaining kidney. No evidence of calculi. A!C 5.8
What is going on? Even with my good renal labs an urine numbers could there be some inflammatory process from remaining healthy kidney or perhaps some sloughing of tissue from what remains of right kidney causing pyuria. MY urologist and PCP say no more need for antibiotics.
I feel great, no urinary symptoms. My obvious concern is potential eventual ascending pyelonephritis into one remaining kidney. What is your best guess? Thanks
Brief Answer:
Need more info
Detailed Answer:
Hello
Thanks for the query
I have noted your history, however I need more info in order to help you
1. What exactly do you mean by renal shut down? Were you taken up for dialysis?
2.. Were your urine sent for Acid- Fast bacilli ?
3. Any sign of prostate enlargement in USG?
4. Was any DTPA scan done to know the functioning of the faulty kidney?
5. No history of fever at all?
Please get back to me, I am awaiting your reply
Regards
Need more info
Detailed Answer:
Hello
Thanks for the query
I have noted your history, however I need more info in order to help you
1. What exactly do you mean by renal shut down? Were you taken up for dialysis?
2.. Were your urine sent for Acid- Fast bacilli ?
3. Any sign of prostate enlargement in USG?
4. Was any DTPA scan done to know the functioning of the faulty kidney?
5. No history of fever at all?
Please get back to me, I am awaiting your reply
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1, They think that probably during the procedure a retractor was compressing renal artery or an embolization post operatively. Diagnosed by renal nuclear scan 6 weeks post surgery.
2. All I know is mycoplasma h./ureaplasma came back negative.
3, No. But did have rectal fullness. Also have internal hemorrhoids. I think the possible prostatitis is why I received Cipro and then Doxycycline. PSA 0.8.
4.That is how they diagnosed the non functioning of kidney.Repeat US since 2010 say kidney is barely visible.
5. No fever. Feeling great. Biking and walking regularly.
Never on dialysis. No Chemo, No radiation. Discharged 2 days post op
2. All I know is mycoplasma h./ureaplasma came back negative.
3, No. But did have rectal fullness. Also have internal hemorrhoids. I think the possible prostatitis is why I received Cipro and then Doxycycline. PSA 0.8.
4.That is how they diagnosed the non functioning of kidney.Repeat US since 2010 say kidney is barely visible.
5. No fever. Feeling great. Biking and walking regularly.
Never on dialysis. No Chemo, No radiation. Discharged 2 days post op
Brief Answer:
Sterile pyuria
Detailed Answer:
Hello
Thanks for getting back, I am sorry for the short delay in my reply. I was on call at my hospital and I just came back.
The condition you are suffering where there are pus cells in urine but culture does not reveal anything is known as sterile pyuria. Here is how you should go about it
1. One common reason for sterile pyuria is infection of the prostate, it is very difficult to treat and requires prolonged treatment for about 8 weeks
2. Send urine for Acid fast bacilli as Tuberculosis of the urinary tract also behaves in the same way
3. I do not think there is acending pyelonephritis, patients with pyelo have symptoms like loin pain and fever with chills. These patients will be very sick and toxic, what you have is either prostatisis or cystitis
4. I recommend that you undergo cystoscopy, please approach your nephro/uro with my suggestion
I hope I was of help, if you have any further queries please get back to me
Regards
Sterile pyuria
Detailed Answer:
Hello
Thanks for getting back, I am sorry for the short delay in my reply. I was on call at my hospital and I just came back.
The condition you are suffering where there are pus cells in urine but culture does not reveal anything is known as sterile pyuria. Here is how you should go about it
1. One common reason for sterile pyuria is infection of the prostate, it is very difficult to treat and requires prolonged treatment for about 8 weeks
2. Send urine for Acid fast bacilli as Tuberculosis of the urinary tract also behaves in the same way
3. I do not think there is acending pyelonephritis, patients with pyelo have symptoms like loin pain and fever with chills. These patients will be very sick and toxic, what you have is either prostatisis or cystitis
4. I recommend that you undergo cystoscopy, please approach your nephro/uro with my suggestion
I hope I was of help, if you have any further queries please get back to me
Regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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